Summary
The Patient Account Specialist is one of a team of Patient Account Specialists who is responsible for protecting and recovering the Midwestern University Clinics patient reimbursements.
The position is part of the Finance Department at Midwestern University and reports to the Manager of Patient Accounts for the Centralized Billing Department.
Essential Duties and Responsibilities
Process claims to include :
- Prepare / submit medical, vision, dental, and workers compensation claims electronically for multispecialty departments
- Print and mail paper insurance claims
- Identify and resolve any claim delay issues that impact billing
- Resolve COB discrepancies
- Follow up on all claims from billing through final resolution to ensure timely receipt of payment
- Resubmit insurance claims within 72 hours from denial receipt
Perform billing functions to :
- Contact payers on unpaid balances
- Prepare write-off requests with appropriate documentation and submit to the Manager of Patient Accounts
- Work within the university clinic policies, procedures and guidelines to coordinate and resolve issues through the understanding and application of collection techniques
- Work system collection reports such as aged trial balances and data searches
- Prepare and follow up on appeals
- Ensure that Federal and state collection / follow-up requirements and regulations are achieved and implement changes directed by regulatory agencies as necessary
- Identify key issues and take appropriate action to ensure revenue maximization on individual accounts
- Perform cashiering, billing, refunds to patient and third parties, payment plans, and collections
- Work in conjunction with the Manager of Patient Accounts to help reach and maintain financial and accounts receivable goals for the clinic
- Assist with cash posting from EFT, Lockbox and Daily Deposits
- Other duties may be assigned
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.
This individual must have the ability to work in a constant state of alertness and safe manner and must have regular, predictable, in-person attendance.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Other qualifications include :
The position requires strict compliance with all policies and procedures. This position requires a significant amount of interaction with the public and many internal customers and therefore, the individual must be able to develop positive rapport effectively
Education and / or Experience
High school diploma or GED and a minimum of 3-5 years accounts receivable experience working in a healthcare setting or medical office environment required.
Knowledge of ICD-10, CPT, HCPCS and medical terminology required. Experience working with Medicare, Medicaid, Third party payers is also required.
Coding certification preferred.
Computer Skills
Computer proficiency in MS Office (Word, Excel, Outlook) is needed. Experience using medical practice management software is required.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit, talk and hear. The employee must regularly use hands to handle or feel and reach with hands and arms.
The employee is occasionally required to stand and walk. The employee must frequently lift and / or move up to 10 pounds and occasionally lift and / or move up to 25 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Midwestern University is a private, not-for-profit organization that provides graduate and post-graduate education in the health sciences.
The University has two campuses, one in Downers Grove, Illinois and the other in Glendale, Arizona. More than 6,000 full-time students are enrolled in graduate programs in osteopathic medicine, dentistry, pharmacy, physician assistant studies, physical therapy, occupational therapy, nurse anesthesia, cardiovascular perfusion, podiatry, optometry, clinical psychology, speech language pathology, biomedical sciences and veterinary medicine.
Over 500 full-time faculty members and 400 staff members are dedicated to the education and development of our students in an environment that encourages learning, respect for all members of the health care team, service, interdisciplinary scholarly activity, and personal growth.
We offer a comprehensive benefits package that includes medical, dental, and vision insurance plans as well as life insurance, short / long term disability and pet insurance.
We offer flexible spending accounts including healthcare reimbursement and child / dependent care account. We offer a work life balance with competitive time off package including paid holiday’s, sick / flex days, personal days and vacation days.
We offer a 403(b) retirement plan, tuition reimbursement, child care subsidy reimbursement program, identity theft protection and an employee assistance program.
Wellness is important to us and we offer a wellness facility on-site with a fully equipped fitness facility.